Perspectives on Frailty Among Emergency Physicians: A Qualitative Descriptive Study
Bibliographic record
Abstract
Background The proportion of older people in the general population is rising. Accompanying this rise is an increased prevalence of frailty. Frailty is a syndrome of increased vulnerability to stressors due to decreased physiological reserve and is linked to increased health services use. Frailty assessment provides a comprehensive insight into an older person's health status but is not regularly performed in emergency departments (EDs) worldwide. Understanding emergency physicians' (EPs) perspectives on frailty could assist in facilitating the implementation of frailty assessments in the ED. However, little is known about EP perceptions of frailty. Objectives The aim of this study was to explore perspectives on frailty among EPs. Design An exploratory qualitative descriptive study was conducted. EPs' perspectives on frailty were explored in semi-structured interviews, including questions on the meaning of frailty, its detection, management, and potential to improve the care of frail ED patients. Interviews were recorded and transcribed. Setting Central Adelaide Local Health Network, which has two EDs in Adelaide, South Australia. Participants Sixteen EPs were interviewed. Eleven (69%) were male EPs and 10 (63%) were practicing as EPs for 4 years or less. Measurements We analyzed interview transcripts by inductive thematic analysis. We generated, iteratively revised, and applied a coding framework, enabling progression to the formulation of themes. Results We developed three themes. Theme 1: EPs did not perceive frailty as a priority of care due to their focus on acuity, and lack of knowledge, time, and resources. Theme 2: EPs referred to detecting and managing frailty indirectly rather than formally. Theme 3: EPs saw a beneficial role in frailty recognition and management in the future. Conclusions EPs did not perceive frailty as a priority of care. However, they had a positive view on progressing with increased frailty awareness and holistic management in EM, for patient and health system benefits.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.016 | 0.029 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.002 | 0.003 |
| Science and technology studies | 0.007 | 0.007 |
| Scholarly communication | 0.004 | 0.005 |
| Open science | 0.002 | 0.005 |
| Research integrity | 0.002 | 0.003 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".